Expert: Harriet B Jacobster, Au.D. - 4/19/2009

Question
My ENT consultant has said that I have an otolith dysfunction where my otoconia have become dislodged but it is not BPPV ( as I feel constant disequilibrium without vertigo which is made worse by walking along and so my otoconia are not putting me in touch with gravity or with acceleration or linear movement.) He did not explain this any further. I wondered if you knew what kind of otoconia problem this is when it can't be classed as BPPV and why I might have got it. It has been really bad for six months except for a day or two here and there. Do you know why I might have had the odd blissful day of remission?
Best wishes,
Geraldine

Answer
Hi Geraldine,
I am not sure what your ENT means by non-BPPV otolith dysfunction. Has he had any tests done?  For example, have you had an Electronystagmography to determine the cause of your disequilibrium?  There are very specific tests to determine the cause of your dizziness.  Without these tests, a definitive diagnosis cannot be made.

Most cases of otolith dysfunction can occur after head injury, or they just may happen spontaneously.  There are actually two different types of otolith dysfunction - at least. The two major conditions are known as cupulothiasis and canalithiasis. The conditions derive their names from part of the vestibular/balance portion of the inner ear known as the cupola and the canalith. Otoliths may dislodge and settle in either one of these portions.  Symptoms are different for each of these conditions and it may be one of these that your ENT is referring to.  

Treatment consists of maneuvering the head to reposition the otoliths back into their proper place.  It is also possible that they reposition themselves, which may account for the symptom-free days that you have described.

Hope this helps.

Harriet B. Jacobster, AuD
Board Certified in Audiology